SPC/ TB Section

Tuberculosis (TB) continues to be a public health issue of major significance around the world. The World Health Organization (WHO) estimates that globally in 2007 there were 9.27 million new cases of TB, of which 44% (or 4.1 million) were infectious.

TB is spread through the air from infectious patients to people in close proximity (i.e. contacts). After exposure to an infectious case, 1–2% of contacts will develop TB, one third will be infected with TB (but won’t have TB disease) and two thirds will remain uninfected. Of the one third who are infected, 5–10% will develop TB disease at some stage during their lifetime and some people are more likely to develop TB than others.

Where adequate resources exist and when most TB cases are being successfully treated, contact tracing of people who have been exposed to TB is important. Although contact tracing can be a resource intensive process, a common approach is to focus on those most at risk of contracting TB and developing severe forms of TB. It is this approach that is the focus of a guideline on TB contact tracing developed by SPC titled: Guidelines for tuberculosis contact tracing in Pacific Island countries and territories. The purpose of the guideline is to standardize contact tracing approaches in the Pacific Island countries and territories. Several Pacific Island countries and territories, especially the French territories, introduced contact tracing into their National TB Programme many years ago. The French territories have harmonised their contact tracing protocols and policies and these are presented in the annex of the contact tracing guideline.

The guidelines contain important information for National TB Programmes on the rationale for contact tracing, identifying contacts, assessing contacts, options for following up contacts, how and when to incorporate contact tracing into a National TB Programme’s activities and how to better record and evaluate contact tracing activities. The guidelines are based on the best available international evidence and incorporate the International Standards of TB Care.

In National TB Programmes that are functioning effectively, the addition of contact tracing to the programme’s activities can increase TB case detection and prevent further cases of TB in people most at risk. The guidelines provide guidance on how National TB Programmes can integrate contact tracing into their TB programme to further decrease the impact of TB on individuals and communities in the Pacific Islands region.